Feasibility of a Smoking Cessation Intervention in Substance Abuse Treatment Programs

Patients in treatment for substance use disorders have a high prevalence of smoking. Treating nicotine dependence in substance abuse treatment settings, however, is uncommon. 

Researchers in this study evaluated the feasibility of implementing a smoking cessation intervention in substance abuse treatment programs. They surveyed, as part of a randomized trial, the program directors, research directors, and 1442 patients from 13 different sites.

• Smoking prevalence was 76%. It was higher at sites that provided methadone (87% versus 66% at sites without methadone) and at sites located in a setting with medical services (85% versus 63% at sites without medical services).
• Most (78%) smokers were interested in quitting, and 64% were willing to enroll in smoking cessation treatment. Interest in quitting and willingness to enroll in smoking cessation treatment were both more common at the sites that provided methadone (e.g., 77% versus 48% willing to enroll) and at sites located in a setting with medical services (e.g., 73% versus 45% willing to enroll).
• Obstacles to performing a smoking cessation intervention identified by sites included the time commitment by staff and scheduling conflicts and low motivation among patients.

Comments:

Smoking is highly prevalent among patients in substance abuse treatment. Although barriers to implementing smoking cessation interventions may exist, these patients, particularly those receiving methadone, are very interested in quitting smoking.  Methadone maintenance programs may offer a unique means of integrating nicotine dependence treatment with substance abuse treatment.

Julia H. Arnsten, MD, MPH

Reference:

Reid MS, Fallon B, Sonne S, et al. Implementation of a smoking cessation treatment study at substance abuse rehabilitation programs: smoking behavior and treatment feasibility across varied community-based outpatient programs. J Addict Med. 2007;1(3):154–160.